Tom Schreck - Out Cold

BACKGROUND INFORMATION

Sergeant Greene had been an active duty sergeant in Special Forces for the last four years. He enlisted during the Iraq conflict, verbalizing he wanted to be part of the nation's war against terror. Greene was cleared of any mental history and did not show any symptomatology consistent with mental illness at the time of enlistment until a series of trauma related events occurring within battle.

The event that appears to have precipitated his current admission involved a raid on a suspected insurgent headquarters within the city of Baghdad. On December 25, 2007, Greene and 3 members of his team entered the house believed to hold the insurgent leaders. Sergeant Greene was the first soldier through the door. He immediately took on fire from two of the insurgents. Greene was not wounded and was able to neutralize his attackers with gunfire.

As Greene and the three members of his team proceeded through the house, they were surprised by another Iraqi who emerged from a closet. Two of Greene's team members were shot, one fatally, before Greene fired upon the assailant. As Greene continued to fire on the Iraqi, he heard the shrieking of several children. When Greene stopped firing and looked into the closet where the Iraqi had emerged he found two young children, a brother and a sister, ages 5 and, 3 dead from his gunfire.

Sergeant Greene had been cleared of any wrong doing in this situation, but the next morning following this incident he was found wandering outside the camp with his firearm. His fellow soldiers were concerned about his behavior and were concerned he might be suicidal. His commanding officer requested psychological services and he was immediately sent to Germany for observation.

Tom Schreck

Out Cold: Round Three of the Duffy Dombrowski Mysteries

MENTAL STATUS EXAM

Sergeant Greene presents as an angry, distrustful individual who did not appear willing to open up, though he wanted to be compliant within the rules of the military. He reported he wasn't sleeping well but "…that he never really did…" When asked if the circumstances that got him referred to psychiatric help bothered him he responded "…wouldn't you be bothered by something like that?"

Initially, Greene appeared oriented to time and place, but while in psychiatric care his stability deteriorated. It may be the case that this is related to his post traumatic condition and as time went by the events of the incident exacerbated Greene's condition as he repeatedly found it difficult to rationalize the events in regard to battle circumstances.

Several medications were tried in an effort to stabilize Greene, but they did not appear to be effective. It may even be the case that his state worsened after medication, though it is impossible to discern if that is a cause and effect related to the medication or just the natural progression of his deteriorating state.

Tom Schreck

Out Cold: Round Three of the Duffy Dombrowski Mysteries

SUMMARY AND RECOMMENDATIONS

Sergeant Greene came to the military with no history of mental illness. At the time of this summary he shows symptoms consistent with Post Traumatic Stress Syndrome. It is quite possible he also has developed schizophrenia with paranoia and some of his behavior suggests substance abuse. It is recommended that Sergeant Greene receive ongoing care for mental illness and substance abuse and that he remain on a regimen of medication to control his reaction to stress.

Theodore Martin, MD

Staff Psychiatrist

Simply put, at least as best as I could understand it, Karl lost it after he accidentally killed a couple of Iraqi kids. If you were going to lose it over something, that would certainly do it. That made some sense, but it didn't really explain the Redskins gear, the rubber gloves, and his theory on the massive plot to fatten all of us with partially hydrogenated oil. On second thought, maybe living with killing a couple of innocent kids did explain that.

I flipped through the rest of the chart, which consisted of his medical history, a section on military mumbo jumbo and the day-to-day case notes. I skipped to the case notes to see if Karl was confronting everyone at the VA who used non-dairy creamer.

Karl was in the funny farm unit for over four weeks so there should be at least a page a day of notes. Hopefully the VA counselors were a little more diligent of their paper work than yours truly and I'd be able to tell what Karl's stay was like. I flipped through the daily progress notes and noticed something wasn't right. The section was too small. The first few days were documented thoroughly then one note went on to a second page and stopped abruptly. Then a brand new page started with two weeks of abbreviated notes. It looked like someone ripped out the original documentation and replaced them with new notes. They did a shitty job because it would've been pretty obvious to anyone who had ever written in a chart. It was even obvious to a counselor who hated paperwork. I was about to get a second opinion from Monique when a shadow blocked the ceiling fluorescent light hanging over me.

"Duffy I left you a note to come see me as soon as you got in," Claudia said.

"I was just coming in."

I followed Claudia to her office.

I'd been down this road before and it wasn't a good road to go down. Getting in trouble at work was something I had gotten used to. Watching The Michelin Woman gloat as she read me her riot act wasn't.

"This is a warning of pending termination," Claudia said glaring at me.

"C'mon Claudia the charts have been worse," I said.

"Oh, I know. That's why this isn't a termination…yet." She half smiled. "It has come to my attention that you have violated a client's confidentiality."

I couldn't imagine how she heard about Karl. The Michelin Woman was a nosy bastard and she would've had her ways, but I decided to keep my mouth shut.

"I received a call from Paula Bentley, the ex partner of your client, Mr. Spain. She says you came to her place of work to advocate that she allow her ex to have visitation with their daughter."

"And I didn't go to her place of employment. I went to pick up that computer and I bumped into her."

"It doesn't matter. It is grossly inappropriate."

"Even so, that's the first time I've ever been caught-I mean-ever done something like that. I've never been warned. You can't fire me for that."

"No, but if you're charts aren't up to date I can combine these two offenses and have just cause to fire you."

"That's a bullshit technicality and you know it." She smiled and closed her eyes.

"Please watch your language in my office." Under my breath I muttered "Fat fuckin' bitch."

"Did you say something?"

"No."

From there, she outlined her plans to can me. She would further investigate my breach of confidentiality and then review my charts. If she was able to confirm that in both cases I was negligent and inappropriate I'd be out on my ass. I've been close to getting canned before, but on those occasions there were always way outs. I wasn't so sure this time.

Tom Schreck

Out Cold: Round Three of the Duffy Dombrowski Mysteries

I finished the day taking a look through my files. I was in deep shit. Claudia had said she'd review the files and investigate my breach in a matter of days. I didn't see any way possible of somehow tying up both ends and saving my ass. I knew this day would come. I just didn't know it would come this week. My friend, the throb, joined me and Elvis for the ride home. Elvis did Are You Lonesome Tonight and he stuttered through the soliloquy in the middle of the song. The way my head felt I could understand the trouble the king had. My stomach did that car-sick feeling, which I knew wasn't related to being in the car. It had more to do with getting hit on the noggin. I pulled up to the Moody Blue and headed toward the door and immediately got the sense something was wrong. I couldn't put my finger on it and wondered if my new emotional state played tricks on me. The one Rudy told me would involve weird unpredictable mood swings. I realized it was much simpler. There was no barking. Every night Al would start going nuts as soon as he heard the El Dorado pull up. Tonight silence. I ran up the steps and bolted through the door, fearing the worst.